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NPI Code Detail

MEDICARE: DR. MAHMOUD NAMIAN D.D.S.

MEDICARE:  DR. MAHMOUD  NAMIAN  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry40689CA

General Provider Information

NPI Number : 1376685990
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAHMOUD NAMIAN D.D.S.
Provider Business Mailing Address
First Line : 609 S ATLANTIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-3211
Country : US
Telephone Number : 323-980-9768
Fax Number : 323-980-0988
Provider Business Practice Location Address
First Line : 609 S ATLANTIC BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90022-3211
Country : US
Telephone Number : 323-980-9768
Fax Number : 323-980-0988
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2007
Last Update Date : 07/08/2007

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Directions to “ DR. MAHMOUD NAMIAN D.D.S.” Practice Location

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